Puleo S, Lombardo R, Li Destri G, Azzarello G, Rinzivillo C, Di Carlo I
Ia Clinica Chirurgica, Università di Catania, Italy.
Hepatogastroenterology. 2000 Sep-Oct;47(35):1379-81.
BACKGROUND/AIMS: In recent years, surgical and non-surgical options have been developed in the treatment of hepatocellular carcinoma in cirrhotic patients. We review our personal series from 1995-1999, in order to assess the choice of treatment.
Of 90 cases of hepatocellular carcinoma observed in the years 1995-1999, 15 underwent curative resective surgery; in 42 cases TAE, PEI or RITA were utilized (9 of them as multimodal therapy). In the remaining 33 patients any kind of therapy was scheduled.
The mean survival of the 15 resected patients was 18 months, non-statistically better than RITA survival, compared by Log-Rank test. Perioperative mortality calculated in all procedures was 5.2% (2 pts surgery, 1 pt TAE).
The high percentage of not treated hepatocellular carcinomas in our series is generally due to large tumor size diagnosed in advanced Child's stage. PEI, TAE and RITA have to be considered effective and safe for palliation for HCCs. However, surgical resection represents the curative therapy in selected cirrhotic patients affected by HCC.
背景/目的：近年来，针对肝硬化患者肝细胞癌的治疗已开发出手术及非手术治疗方案。我们回顾了1995年至1999年期间的个人病例系列，以评估治疗方案的选择。
在1995年至1999年观察到的90例肝细胞癌病例中，15例接受了根治性切除手术；42例采用了经动脉栓塞化疗（TAE）、经皮乙醇注射（PEI）或射频消融（RITA）（其中9例采用多模式治疗）。其余33例患者未安排任何治疗。
15例接受手术切除患者的平均生存期为18个月，经对数秩检验，与接受RITA治疗患者的生存期相比，差异无统计学意义。所有手术的围手术期死亡率为5.2%（2例手术患者，1例TAE患者）。
我们的病例系列中未接受治疗的肝细胞癌比例较高，这通常是由于在晚期Child分级阶段诊断出肿瘤体积较大。对于肝细胞癌的姑息治疗，PEI、TAE和RITA被认为是有效且安全的。然而，手术切除是某些受肝细胞癌影响的肝硬化患者的根治性治疗方法。
